A guide to the Criminal Injuries Compensation Scheme 2012

Transcription

1 A guide to the Criminal Injuries Compensation Scheme 2012 Criminal Injuries Compensation Authority June 28, 2013

2 Crown Copyright 2012 You may re-use this information (excluding logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit or Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned.

3 A guide to the Criminal Injuries Compensation Scheme 2012 i Contents SECTION 1 Introduction 1 What is the Criminal Injuries Compensation Scheme? Purpose of this guide What payments are available from the Scheme? Applying for a payment How do you apply for a payment? Getting independent help with your application Free independent advice Paid representation Other help Applying on behalf of children Applying on behalf of an adult who cannot apply by themselves If you were injured outside Great Britain SECTION 2 Eligibility 6 Circumstances in which you may be eligible for a payment Direct victim of a crime of violence Claiming after a period of abuse Injured while taking an exceptional and justified risk Being present at and witnessing or being involved in the immediate aftermath of an incident Fatal injuries Timescales Applicants aged 18 or over on the date of the incident Applicants under 18 years of age on the date of the incident Residency and nationality Further eligibility requirements SECTION 3 Application process 13 Making an application Evidence Medical evidence Your obligations Your consent and signature How we will deal with your claim SECTION 4 Payment types and their qualifying conditions 17 What happens if you have more than one injury? Loss of earnings payments

4 ii A guide to the Criminal Injuries Compensation Scheme 2012 Claiming loss of earnings Special expenses Bereavement payments Child s payments Dependency payments Financial dependency Physical dependency What happens if a person dies of the injuries at a later date? Where the victim dies of an unrelated cause before a payment is made to them Future loss, special expenses and dependency payments as a lump sum. 24 Funeral payments SECTION 5 Withholding or reducing an award 26 Reporting Co-operation with the police and the Criminal Justice System Co-operation with us or another body Conduct Excessive consumption of alcohol or use of illicit drugs Criminal record Character Conduct and character of deceased victims SECTION 6 Decisions and administering payments 29 Accepting a payment How we make a payment Payments to adults who manage their own financial affairs Interim payments Trusts Annuities Appointment of a deputy or guardian If you are under 18 when a payment is made Repayment of awards SECTION 7 Re-opening cases, reviewing our decisions and how to appeal 33 Re-opening a case Reviewing our decision Appealing a decision SECTION 8 Customer service 35

5 A guide to the Criminal Injuries Compensation Scheme 2012 iii Customer charter What we ask of you Our commitments to you Complaints Customer survey Appendix 1 Further information about eligibility for residents and non-residents 37 Ordinarily resident in UK Other ways of meeting the residency or nationality criteria EU and EEA member states Evidence Residency Nationality Serving member of Her Majesty s armed forces Appendix 2 Criminal convictions 45 Taking account of your criminal record Other convictions Sentences given after you apply Appendix 3 Tariff of injuries 50

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7 A guide to the Criminal Injuries Compensation Scheme SECTION 1 Introduction What is the Criminal Injuries Compensation Scheme? 1. The Criminal Injuries Compensation Scheme is a government funded scheme to compensate blameless victims of violent crime. Payment can never fully compensate for the injuries suffered, but it is recognition of public sympathy. 2. The Scheme is for people injured in England, Scotland and Wales (Great Britain). Northern Ireland has its own Scheme, as do many other countries. 3. The rules of the Scheme and the value of the payments awarded are set by Parliament. The Criminal Injuries Compensation Authority ( the Authority ) administers these rules. Payments are calculated by reference to a tariff of injuries. In certain circumstances you may also be entitled to additional payments for loss of earnings and special expenses (see section 4 of this guide for more information). Purpose of this guide 4. This guide is for blameless victims of violent crime or their representatives who are thinking of applying, or who have applied, for compensation under the Criminal Injuries Compensation Scheme 2012 (we call this the Scheme ). The 2012 Scheme applies to all applications received on or after 27 November Welsh language copies of the 2012 Scheme are available. 5. This guide refers only to the 2012 Scheme and aims to assist applicants in understanding the Scheme. It tells you how to make an application and how your claim will be handled and explains the eligibility rules and your responsibilities. This guide should be read in conjunction with the Scheme, which remains the authoritative document. 6. You can get a copy of this Scheme (or earlier Schemes and guides if you applied before 27 November 2012) from our website What payments are available from the Scheme? 7. We can consider claims for the following: personal injury following a single incident;

8 2 A guide to the Criminal Injuries Compensation Scheme 2012 personal injury following a period of abuse; loss of earnings; special expenses payments to cover specific injury-related requirements which are not available free of charge from any other source; fatal injuries, including loss of parental services and financial dependency; and funeral payments. Applying for a payment 8. The Scheme is intended to be one of last resort. We expect you to try to claim compensation from the person, or persons, who caused your injury or loss. You may also be able to claim from someone who was indirectly responsible for your injury. However, if you do not know who injured you, or your assailant does not have the means to pay you compensation, you can make a claim under the Scheme. 9. If you are trying or planning to claim compensation from someone else, you must tell us when you apply and you must keep us informed of progress with your other claim. 10. You must make your claim to us within two years of the incident. You should not wait to find out if other claims are successful. However, we will not make a final decision on your case until you confirm that you have exhausted other routes to compensation. How do you apply for a payment? 11. We offer two ways to make a claim for compensation: Online, at and By telephone. Our Customer Service Centre advisors can assist you to make a claim over the telephone. If you wish to apply in the Welsh language, please download, complete and return a Welsh-language application form from our website. 12. Full details on the application process are provided at Section 3 of this guide.

9 A guide to the Criminal Injuries Compensation Scheme If you are unsure about whether or not you are eligible for a payment, or have a question about the application process our Customer Service Centre staff will be happy to give you advice. For advice about eligibility, or if you want one of our team to help you make a claim, please call The team are available from 08:30 to 17:00 except Wednesday when we are open from 10:00 to 17: Not all claims for compensation will be successful; you must be eligible under the rules of the Scheme. Eligibility requirements are provided at Section 2 of this guide. Getting independent help with your application Free independent advice 15. If you want free independent advice and help to complete your claim, this may be available from Victim Support or other charitable organisations. 16. Victim Support is an independent national charity for people affected by crime. Victim Support gives free and confidential support, and practical help to victims and witnesses of crime. This can include helping you with your claim. You can contact them by: telephoning the Victim Supportline on (England and Wales) or (Scotland); visiting their website at or or ing supportline@victimsupport.org.uk or info@victimsupportsco.org.uk. 17. Victim Support cannot provide legal advice. 18. You can also get advice from your local Citizens Advice service, a law centre, or from a welfare rights organisation. If you belong to a trade union, they may be able to help.

10 4 A guide to the Criminal Injuries Compensation Scheme 2012 Paid representation 19. You do not need a paid representative (for example, a solicitor or a claims management company) to make a claim. If you choose paid representation we cannot meet the cost of this, and you will have to pay these costs yourself. Where someone is representing you on a no-win no-fee basis this usually means that they will keep a share of your payment to cover their fees. You should always check how much of your payment will go to your representative before you agree to paid representation. Other help 20. You can get a friend or a relative to make a claim on your behalf and/or represent you. Applying on behalf of children 21. If you are applying on behalf of a child who was injured, you should complete the claim form, answering the questions as if you were the injured person. You will be asked to provide your details and proof of your relationship to the child. Applying on behalf of an adult who cannot apply by themselves 22. If you are applying on behalf of an adult who cannot apply by themselves, you should complete the claim form by answering the questions as if you were the injured person you are representing, and sign the claim on their behalf. 23. You will also be asked to provide your details. In all cases where an adult lacks the capacity to make their own claim, we will need full details about your status and the extent of your legal powers as well as evidence that you are entitled to act on their behalf. 24. If the person does not already have someone who is entitled to act on their behalf, then you could consider applying to the Court of Protection for the appointment of a deputy (England and Wales) or a financial welfare guardian or for an intervention order (Scotland). There is more information at (England and Wales) or

11 A guide to the Criminal Injuries Compensation Scheme (Scotland). This will allow the deputy or guardian to: authorise all the enquiries we need to make of others; decide whether to accept a payment on behalf of the injured person; ask for a review; or appeal to the First-tier Tribunal (Criminal Injuries Compensation). 25. In these circumstances we will also need you to give us medical evidence that the person you are representing lacks capacity, or is incapable by reason of mental disorder, within the meanings of the Mental Capacity Act 2005 (England and Wales) or Adults with Incapacity (Scotland) Act If you were injured outside Great Britain 26. If you are a United Kingdom (UK) resident and were injured as a result of a crime of violence in another country which is part of the European Union (EU) we can help you apply for compensation from that country. Please call our EU Assistance Team on or eucat@cica.gsi.gov.uk. Details of compensation schemes in other countries can be found on the EU Judicial Atlas on the internet. 27. If you were injured outside the EU, you may be able to apply under a similar scheme operated by the country concerned. Please contact the Foreign and Commonwealth Office for more information. 28. If you were injured in Northern Ireland, you should contact: The Compensation Agency Sixth Floor Millennium House 25 Great Victoria Street Belfast BT2 7AQ Telephone: If you were ordinarily resident in the UK and you were injured outside the UK in a terrorist attack, you may be able to claim under the Victims of Overseas Terrorism Compensation Scheme. Please see our website for more information at

12 6 A guide to the Criminal Injuries Compensation Scheme 2012 SECTION 2 Eligibility Circumstances in which you may be eligible for a payment 1. You may get a payment if you: were a direct victim of a crime of violence; were not to blame for the incident; sustained an injury while taking an exceptional and justified risk, while trying to remedy or prevent a crime; sustained a mental injury as a result of witnessing or being involved in the immediate aftermath of an incident in which a loved one is injured; or are a qualifying relative of a victim who has died from injuries caused by a crime of violence. Direct victim of a crime of violence 2. A direct victim is someone who was directly injured by an assailant. 3. There is no legal definition of the term a crime of violence. Annex B of the Scheme does, however, describe the types of crimes of violence which can lead to an injury which can be compensated under the Scheme. 4. You may be eligible for a payment if the criminal injury you sustained resulted from: a physical attack; any other act or omission of a violent nature which causes physical injury to a person; a threat against a person, causing fear of immediate violence in circumstances which would cause a person of reasonable firmness to be put in such fear; a sexual assault to which a person did not in fact consent; or arson or fire-raising. 5. The above will only constitute a crime of violence if there was intention on the part of the assailant to cause you harm, or if the injury sustained was

13 A guide to the Criminal Injuries Compensation Scheme because of the intentional or reckless behaviour of an individual who was likely to have foreseen that their actions could cause significant injury to another, and proceeded to act regardless of this outcome. 6. An omission is considered a crime of violence if the omission could be described as being violent in nature (such as knowingly withholding something that another person needs to stay alive) and resulted in a physical injury. 7. We can also treat an act as a crime of violence where the assailant is not capable because of insanity and lacks the necessary mental capacity, or is a child who is below the age of criminal responsibility but understands the consequences of their actions. 8. You will not be eligible for a payment if the injury you sustained: resulted from suicide or attempted suicide, unless the suicidal person acted with intent to cause injury to another person; resulted from the use of a vehicle, unless the vehicle was used with intent to cause injury to a person; resulted from an animal attack, unless the animal was used with intent to cause injury to a person; was sustained in the usual course of sporting or other activity to which a person consented by taking part in the activity; or was sustained in utero as a result of harmful substances willingly ingested by the mother during pregnancy, with intent to cause, or being reckless as to, injury to the foetus. 9. In paragraph 8, vehicle means any device which can be used to transport persons, animals or goods, whether by land, water or air. Claiming after a period of abuse 10. If you, or someone for whom you have responsibility, has been injured because of a period of physical or sexual abuse, you can make a claim for compensation. 11. If you were abused as a child, we appreciate that you may not have felt able to report the incident for some time after the abuse happened. No matter how long ago the abuse took place, you should report it to the police before you make a claim. We need to check with the police that the crime has been reported. If you have not reported the incident to the police we will refuse your claim.

14 8 A guide to the Criminal Injuries Compensation Scheme 2012 Injured while taking an exceptional and justified risk 12. The Scheme can also compensate you if you are injured while trying to prevent or remedy the consequences of a crime (including where you were trying to help the police apprehend a suspected offender). 13. If you are making a claim under these provisions, we will need to be satisfied that you were taking an exceptional risk and that this risk was justified in all the circumstances. 14. When deciding if the risk was exceptional, we will consider if what you did was unusual, and was not something which you were trained to deal with. We will not compensate people who were injured while doing something that would be expected of them in the course of their normal employment. 15. When considering if the risk was justified we will consider all the circumstances, including the seriousness of the situation, and whether there was an immediate threat to those involved. Being present at and witnessing or being involved in the immediate aftermath of an incident 16. You may be eligible to make a claim for a mental injury if you witnessed, and were present at, an incident in which a loved one was injured as the result of a crime of violence. You may also be eligible if you were involved in the immediate aftermath of an incident in which a loved one was injured. 17. When we say immediate we are referring to the incident itself and not the events that might follow an incident (such as dealing with the police and medical authorities). By aftermath we mean events that happened straight after the incident. For the purpose of this Scheme it will be taken to mean arriving at the scene of the incident before the victim is moved to another location. 18. If you are claiming a payment because you witnessed, or were involved in the immediate aftermath of, the injury of a loved one, you must have suffered a mental injury as a result. We will need a psychiatric diagnosis confirming that this is the case.

15 A guide to the Criminal Injuries Compensation Scheme Fatal injuries 19. If you are the dependant and/or a close relative of a person who dies as a result of their injuries, you may be able to claim a payment. To be eligible for such payments you must be what the Scheme calls a qualifying relative. This is someone who, when the victim died, was in one of the following groups: the victim s spouse or partner registered under the Civil Partnership Act You must either have been living together in the same household at the time of the deceased s death, or, if you were not living together, this must have been because of ill-health or infirmity; the unmarried partner of the victim, if you were living together as husband and wife or as partners of the same sex (although not registered under the Civil Partnership Act 2004), at the time the victim died and for at least two years before that; the natural or adoptive parents of the deceased, or a person the deceased accepted in the role of parent and who provided the deceased with parental services; or the child of the victim, or a person who the deceased accepted as their child and who was dependent on the deceased for parental services. 20. You may also be considered as a qualifying relative if you are the victim s former spouse or partner registered under the Civil Partnership Act 2004 and were financially dependent on the victim at the time they died. In such cases you may be eligible to apply for a dependency payment. You will not be eligible for a bereavement payment. 21. The definition of child is not limited to a person below the age of 18. It includes adult children and an unborn child of the deceased, conceived before they died and born alive after they died. The parents of a victim can receive a payment whatever the age of the victim. 22. You may be able to get a payment if the victim has died from their injuries, even if we made a payment to the victim before they died. 23. A person who was responsible for the death of a victim cannot get a payment as a result of the death. 24. We cannot make a payment to a qualifying relative if they were estranged from the victim at the time of their death.

16 10 A guide to the Criminal Injuries Compensation Scheme As with all claims, if the behaviour of the victim led or contributed to the incident in which they were fatally injured we will not normally make a payment. Where a victim dies from their injuries we have to apply these rules to the victim and the applicant. 26. The character of the deceased, as shown by their criminal convictions, will not ordinarily be taken into account. However, we will refuse to make a payment where the deceased s convictions or crimes were so serious that to pay for their funeral, or to make other payments, would be an inappropriate use of public funds. Situations where we might consider it inappropriate to make an award will include where the deceased: was serving a custodial sentence at the time of the incident; had a long history of involvement in violent crime; was a known extremist who had incited hatred or violence; or was a known member of a gang which had been involved in violent crime. 27. We look only at convictions which are not spent under the Rehabilitation of Offenders Act. Timescales Applicants aged 18 or over on the date of the incident 28. You must apply for a payment within two years of the date of the incident which led to you being injured. In exceptional circumstances we may extend this time limit but only where: the circumstances of your injury meant that we could not reasonably have expected you to apply within the two-year time limit; and the evidence you supply in support of the application means we can make a decision without further extensive enquiries. 29. In deciding whether there are exceptional reasons for you not to have applied earlier we will consider if: there is medical or psychiatric evidence available which shows that it was not possible for you to have applied earlier; and there is clear evidence available that there was a crime of violence and that you were the victim. We will make basic enquiries of the police, but you

17 A guide to the Criminal Injuries Compensation Scheme will need to be able to provide evidence that you were a victim of a crime of violence and that you suffered an injury as a result. 30. We would not usually consider the applicant s lack of knowledge of the Scheme to be an exceptional reason. Applicants under 18 years of age on the date of the incident 31. If you are under 18, it is best if someone applies on your behalf as soon as possible. This is because it may be harder for you to provide evidence that you were injured as the result of a crime of violence if you wait until later. 32. If the incident or period of abuse was reported to the police before you turned 18, and no-one made a claim on your behalf, we will accept a claim from you providing that you make it before you turn If the incident or period of abuse took place before you turned 18, but was not reported to the police at the time, we will consider your claim if it is made within two years of the date when the incident was first reported to the police. Residency and nationality 34. You will only be eligible for a payment if you meet the residency or nationality requirements. This means that you must have been ordinarily resident in the UK on the date of the incident or that one of the following conditions is met: you are a British citizen; you are a close relative of a British citizen; you are a national of a member state of the European Union (EU) or the European Economic Area (EEA); you are a family member of an EU/EEA national who has a right to be in the UK; you are a national of a State party to the Council of Europe Convention on the Compensation of Victims of Violent Crimes (CETS No.116, 1983); you are a member of Her Majesty s armed forces, or an accompanying close relative of an armed forces member;

18 12 A guide to the Criminal Injuries Compensation Scheme 2012 you have been identified as a potential victim of human trafficking on or before the day of your application; or you made an application for asylum to remain in the UK on or before the day of your application for an award. 35. More information on nationality and residency (including human trafficking and asylum) eligibility requirements is available in Appendix When we get your claim we will tell you what information we need from you to establish your residency and nationality and we will verify this as needed. If you do not supply information that we ask for, we may refuse your payment. Further eligibility requirements 37. You cannot get a payment if: the incident or period of abuse which resulted in the injury was not reported to the police; you were injured before 1 August 1964; you have already applied for compensation for the same criminal injury, whether under this or any other Scheme (if you deliberately apply for compensation for the same injury more than once, you may be prosecuted for attempted fraud); the injury happened before 1 October 1979 and you and the person who injured you were living together at the time as members of the same family (the Scheme changed at this time); the injury happened on or after 1 October 1979 and you and the person who injured you were adults living together as members of the same family at the time and continue to do so; the person who injured you could benefit from your award because there is a continuing close link between you (the victim) and the assailant.

19 A guide to the Criminal Injuries Compensation Scheme SECTION 3 Application process Making an application 1. To have your claim considered you must complete our application form. You can apply online at If you do not have access to a computer or you would like help to complete your application, you can ask one of our staff to complete the form for you over the telephone ( ). 2. The onus is on you to prove that you are eligible for a payment. This means that you will need to provide us with the evidence necessary to decide your case. In addition to the evidence you provide, we may get a report from the police and, where necessary, we will commission and pay for additional medical evidence. 3. We will not investigate your claim further until we know that you are likely to meet the basic eligibility criteria set out in Section 2 of this guide. Before we ask you for any evidence, we will try to speak to you, or your representative, on the telephone so that we can establish what evidence is needed to decide your claim. If you have indicated on your application form that you do not want to deal with us by telephone, we will use your preferred method of communication ( or letter). Evidence 4. We will ask you to provide the following evidence: proof that you meet the residency requirements; basic medical evidence that shows you suffered an injury that can be compensated under the Scheme (in the case of a sexual assault this will only be necessary where you are claiming for an injury which requires a medical opinion). 5. We will collect the following evidence: confirmation from the police that the incident in which you were injured was reported to the police; confirmation from the police and/or witnesses that your behaviour did not contribute to the incident in which your injuries were received; additional medical evidence, as required.

20 14 A guide to the Criminal Injuries Compensation Scheme 2012 Medical evidence 6. When we agree what medical evidence is required you will be expected to meet the costs of providing initial medical evidence up to a maximum cost of 50. Where you can demonstrate that you cannot reasonably afford to obtain it, or the cost exceeds 50, we will consider meeting the costs. Where we do this, we will deduct the cost (up to the 50 maximum) from any payment. 7. We may need additional medical or other evidence if your injuries are complex or you are claiming for a mental illness. We may also need to check if you have any pre-existing conditions, if that has not already been covered in the initial medical evidence. In these circumstances we will either ask your treating practitioner for a report or we may arrange for you to be seen by another expert. Where we do seek additional medical or psychiatric evidence we will meet the cost of obtaining it. 8. If we ask you to see an expert, you must keep the appointment. We will meet the reasonable cost of you travelling to and from the appointment. If you miss the appointment, without good reason, we may deduct any costs we have to pay from any payment we make. 9. If you provide your own medical evidence in support of your claim we will not pay any share of this, unless we rely on it to decide the claim. 10. If you qualify for a payment under the tariff of injuries (as listed at Appendix 3) you may also qualify for a payment for loss of earnings. This will only be the case where your injuries resulted in you having no, or very limited, capacity for paid work. To claim loss of earnings you must be able to show that you were either in paid work at the time of the incident, you were in regular paid work for at least three years immediately before the date you were injured; or you had a good reason for not being in regular paid work for those three years. More information on claiming loss of earnings is available at Section You may also be able to claim for special expenses if your injuries mean that you need ongoing care and support which is not available free of charge from another source. More information on claiming special expenses is available at Section 4. Your obligations 12. Paragraph 91 of the Scheme outlines the applicant s obligations. You must:

21 A guide to the Criminal Injuries Compensation Scheme make your application on the form available from us, either completing this online, or over the telephone; comply with any direction made or condition imposed by a claims officer. For example, by keeping any medical or psychiatric appointments and providing any documents we ask to see which support your claim; inform the claims officer of any other claims you are pursuing or other proceedings you are involved in in relation to the same injuries and keep us informed of the progress of such claims or proceedings; assist the claims officer, and any other body or person, as far as reasonably practicable in relation to the consideration of your application; and provide the claims officer with any change in your correspondence address as soon as reasonably practicable. Your consent and signature 13. We will ask you to provide signed consent for the release of all the records, evidence and other relevant information about you and the circumstances of your injury. This will help us make the right decision about your claim. We look at: the evidence you gave to the police; criminal records; and additional medical evidence (if required). 14. If you are claiming for loss of earnings or special expenses we may also look at information about your income from the Department for Work and Pensions and/or HM Revenue & Customs. 15. We will ask you to confirm that the information you provide in your claim is true. If we find that you deliberately gave us false information or failed to give us information we asked for (for example, criminal records or details of other claims) we will refuse your claim. How we will deal with your claim 16. When we have a fully completed application from you, we will give you a personal reference number which will help us to identify it quickly if you need to contact us.

22 16 A guide to the Criminal Injuries Compensation Scheme One of our regional casework teams will handle your claim. If you phone for advice or an update on your claim, you will speak to one of our Customer Service Centre advisors. We will always try to answer your query while you are on the line but if we can t do this, we will arrange to get in touch with you at a convenient time. 18. The length of time needed to assess your claim will vary depending on how complicated it is. For example, claims involving loss of earnings and special expenses will take longer than those involving only a payment made under the tariff of injuries. We will not finalise your claim until you confirm that you have recovered, as far as possible, from your injuries. 19. When we have all the evidence we need to decide your case, it will be passed to a claims officer. Claims officers decide cases on what is called the balance of probabilities. This means that their decision is based on their view of what is more likely to have happened than not to have happened. 20. We will inform you of our decision on your claim as soon as it is made. If we have reduced or refused a payment, we will tell you why. We will send you information about what to do if you don t agree with our decision.

23 A guide to the Criminal Injuries Compensation Scheme SECTION 4 Payment types and their qualifying conditions 1. The Scheme provides compensation payments to those with the most serious injuries and those who have been the victim of the most distressing crimes. We are able to consider a claim for one or more of the following types of payment: injury payments; loss of earnings payments; special expenses payments; bereavement payments; child s payments; dependency payments; certain other payments in fatal cases; funeral payments. 2. You may be eligible for a payment under the Scheme if your criminal injury is described in the tariff of injuries which can be found at Appendix 3. If you already had an injury which is listed in the tariff but it has been made worse as a result of a crime of violence you may still be entitled to a payment. Where the value of the acceleration or exacerbation of an existing condition is less than 1,000, no payment will be made. 3. If you suffer a mental injury as a result of a sexual assault, we will pay you either the tariff value for the type of assault or the value of the mental injury. We will pay whichever has the highest value; you will not receive a payment for both. This is because the tariff for a sexual assault takes account of the mental trauma. 4. If you need to have an operation as a result of the injury you will not receive a separate payment for scarring arising from the operation. What happens if you have more than one injury? 5. If you have two or more injuries so serious that each, on its own, would qualify, you will be entitled to: 100 per cent of the full tariff value of the most serious injury; and

24 18 A guide to the Criminal Injuries Compensation Scheme per cent of the tariff amount for the injury with an equal or second highest value; plus 15 per cent of the tariff amount for any additional injury with an equal or third highest value. 6. The Scheme does not allow us to pay for more than three injuries. However, there are additional tariff payments which you can receive if, as a direct result of your injury or assault, you: become pregnant; lose a foetus; or contract a sexually transmitted disease. Loss of earnings payments 7. If you are unable to work as a direct result of a criminal injury you may be eligible to claim a loss of earnings payment. 8. Your criminal injury must be serious enough to have resulted in a total inability to undertake paid work, or a very limited capacity to do so. By very limited capacity we mean that the extent of your injuries means that you are not able to undertake more than a few hours of paid work per week. If you have capacity for paid work, but the type of work is limited because of your injuries, you will not qualify for a loss of earnings payment. 9. You must also be able to provide evidence to show that: you were in work at the time of the incident; or you have an established work history, or a good reason for not having such a history, during the three years immediately prior to the incident; and your loss lasted longer than 28 full weeks. The period of 28 weeks will usually run from the date of the injury. You cannot get loss of earnings for the first 28 weeks of loss. Claiming loss of earnings 10. When we get your claim we will tell you what information we need from you and we will verify this as needed. You will be expected to provide evidence supporting your claim for loss of earnings. This might be pay slips or a P60 for

25 A guide to the Criminal Injuries Compensation Scheme the period immediately before you were injured, or a formal offer of a job which you were unable to take up because you were injured. If you were self-employed, we may ask for a copy of your tax returns, or for correspondence from HM Revenue & Customs to show that you were in regular paid work. 11. We will calculate the length of any payment, beginning after you have lost 28 weeks of earnings up until whichever is earliest of: the day you are no longer incapable of any paid work; the day on which you will reach state pension age; and the expected end of life where the injury has shortened that period. 12. The loss of earnings payment will be made at a fixed rate per week of loss. The fixed rate used will be the rate of statutory sick pay in force at the date of deciding your claim. Special expenses 13. The Scheme allows us to consider claims for certain costs referred to as special expenses which you may have incurred as a result of your injury. 14. You can only ask us to consider a claim for special expenses if your injuries mean you have been unable to work, or have been incapacitated to a similar extent, for more than 28 weeks. We will, however, pay the special expenses from the date of the actual injury. This is different from the loss of earnings rule where we can pay only from week In order to qualify for a special expenses payment you must be able to prove that the goods or services, or something similar, is not available free of charge from another source. The expense must also be: necessary; incurred as a direct result of a criminal injury; and reasonable. 16. You may claim for damage to property or equipment belonging to you which you relied on as a physical aid and which was damaged in the incident. Examples would include walking sticks, spectacles and dentures. We will ask you for receipts for these. 17. You may also be able to claim for expenses such as NHS prescriptions, and dentists and opticians charges. We may consider meeting these costs only if you

26 20 A guide to the Criminal Injuries Compensation Scheme 2012 had to pay them yourself. Again, we will need proof of this. You may be able to get help for some of these costs from the NHS. You can get more information about this from: Health Benefits Division Sandyford House Archbold Terrace Newcastle-upon-Tyne Tyne and Wear NE2 1DB Telephone: If you require special equipment; for example, physical aids (including specially-adapted vehicles, wheelchairs and walking aids and kitchen implements to help people whose grip has weakened) you may be able to claim. If you have bought these, we will ask you for receipts or an estimate. 19. We may pay for adaptations to your home, which can include changes both inside and outside your home (such as a ramp or a stair lift) to improve your independence or ability to get around. 20. We may pay the cost of care relating to your bodily functions, or to the preparation of meals and supervision (to avoid substantial risk to you and others). 21. We may pay the costs of appointing someone to administer a mentally incapacitated applicant s affairs, and the costs of ongoing administration of those affairs. 22. We may pay the cost of setting up a trust where we have directed this under paragraph 106 of the Scheme, but not any costs associated with administering that. 23. Since we will meet costs only if they cannot be met by the NHS or your local authority, we will need to get a copy of the local authority care report showing what they will provide and what, if anything, additional will be needed. 24. We must avoid any double payment. So we have to reduce any payment for special expenses to take account of social security benefits you receive or could receive to meet any of the same expenses. If the benefit is available to you, we have to take account of it, whether or not you choose to claim it. The Scheme says that if you could receive any social security or other state benefits, we may defer making a decision until you have taken steps to claim them. 25. The rules on reducing payments to take account of insurance payments are

27 A guide to the Criminal Injuries Compensation Scheme more complicated. For loss of earnings we will reduce the award if you have received money for the same loss from an insurance policy which someone else paid for or contributed to, but not if you paid for it yourself. 26. Where special expenses are awarded we will reduce your payment to take account of insurance paid, regardless of who paid the premium if you are claiming for things like adaptations to your home or personal care. Bereavement payments 27. If you are a qualifying relative (as explained in Section 2) and were not divorced or estranged from the deceased at the time of death, you may be eligible for a bereavement payment of: a fixed sum of 11,000 if you are the only qualifying relative; or a fixed sum of 5,500 for each person who qualifies for a payment. Child s payments 28. You may claim for a child s payment if the child is a qualifying relative who was under 18 at the time of death and dependent on the deceased for parental services. This is an amount of money to provide some small recognition of what a child loses as the result of the death of a parent, such as: love and affection; care and supervision; being taken to and from clubs and activities; and treats. 29. The entitlement to which a child s payment will relate begins on the date of death and ends on the day before the child s 18th birthday. The child s payment is 2,000 for each full year, proportionally reduced for part years. We calculate this as a lump sum. 30. We may also be able to pay an additional amount for such expenses suffered by the child as a direct result of the loss of parental services as a claims officer considers reasonable.

28 22 A guide to the Criminal Injuries Compensation Scheme 2012 Dependency payments 31. You may claim for a dependency payment if you were a qualifying relative who was financially or physically dependent on the deceased at the time of their death. Financial dependency 32. To be eligible, at the date of death the deceased victim must have been either: in paid work; not in paid work but had regularly been in paid work in the three years prior to the date of death; or not in paid work and had good reasons for not being so, for example, they were unable to work because they were in full-time education, or by reason of their age or caring responsibilities. 33. We will not make a financial dependency payment if the deceased relied on social security benefits as their main income. 34. The payment is calculated over the period of dependency at the weekly rate of statutory sick pay at the date of decision. 35. The eligible period of payment begins on the day of death, and ends on whichever is the earliest of: in the case of a qualifying relative who is a child under the age of 18, the day before their 18th birthday; the day upon which the deceased would have reached state pension age; the date on which, before the incident giving rise to their criminal injury, the deceased s life would have been expected to end in accordance with Table C of Annex F of the Scheme or other available medical evidence; the expected end of the qualifying relative s life; or the 50th anniversary of the date the deceased died. 36. If there is more than one qualifying relative eligible for a financial dependency payment, the weekly amount will be divided in equal shares between the claimants that qualify during that week. As the number of qualifying

29 A guide to the Criminal Injuries Compensation Scheme relatives reduces (for example, when a child turns 18), remaining claimants will qualify for an increased share of the payment. 37. The dependency payment will be made in a lump sum. Physical dependency 38. If you are a qualifying relative and the deceased was your main carer you may be eligible for a physical dependency payment. We define a main carer as the person who met the majority of an applicant s care needs. The period of loss for which we may be able to provide a payment starts from the date the victim died. 39. We consider a claim for physical dependency in the same way as we would for a financial dependency claim; that is, that the conditions outlined in paragraphs would need to be met. 40. Physical dependency includes the following: assistance with personal hygiene (toileting/bathing); continence management; food preparation and eating; medication and simple treatments; or supervision of the applicant where this is necessary and actively takes place throughout the day. What happens if a person dies of the injuries at a later date? 41. We may be able to make a payment after a victim s death even if they got a payment for their injury before they died. If the victim has died because of their injury, qualifying relatives may be eligible to claim. The payment to the victim will affect the payment to relatives as follows: if there is only one person eligible for a dependency or child s payment we will reduce this by the amount that has already been paid to the deceased; if there is more than one person eligible for a dependency or child s payment we will reduce this by the amount that has already been paid to

30 24 A guide to the Criminal Injuries Compensation Scheme 2012 the deceased, split proportionally between all recipients. For example, if the deceased had received 3,000 prior to their death, and three eligible recipients made a claim, their total payment would be reduced by 1,000 each. 42. If you apply for a payment where the victim had already received a payment before they died and it is more than two years since we settled their case, we can only deal with your application if it will not need extensive enquiries. This means there would need to be very little or no doubt that their death was directly as a result of the criminal injury. Where the victim dies of an unrelated cause before a payment is made to them 43. A qualifying relative of a person who sustained a criminal injury but who has died otherwise than as a direct result of that injury may be eligible for a payment if on the date the deceased died: the deceased was eligible for a special expenses payment but had not received it; and they were financially dependent on the deceased. 44. The payment to which the qualifying relative may be entitled is limited to: any loss of earnings that the deceased may have been entitled to before the date of death; any special expenses (as allowed under the Scheme) which were incurred by the deceased before the date of death. 45. For the avoidance of doubt, no payment will be made to any surviving relatives for the personal injury element of a claim. Future loss, special expenses and dependency payments as a lump sum 46. We will make a payment in a single lump sum, so we need to convert the part of your payment that relates to future loss into a single lump sum which we can pay now. We do this by calculating the full value of the payment and then reducing it to reflect the fact that we are paying it in advance.

31 A guide to the Criminal Injuries Compensation Scheme The Scheme sets out the multiplier that we will use to convert the total value of your payment into a present day value. 48. The size of the multiplier depends on the duration of your entitlement. For example, when assessing future loss of earnings this is based on the period you are unable to work in the future the longer that period, the higher the multiplier. Funeral payments 49. Where a person has died as a result of sustaining a criminal injury, we may make a funeral payment in respect of their funeral expenses. 50. A flat rate funeral payment of 2,500 can be made as soon as basic eligibility has been established. This is intended to cover the costs of a basic funeral. 51. A further payment of up to 2,500 may be payable where the particular circumstances mean that the flat rate will not cover the cost of a basic funeral. The total amount of a funeral payment cannot exceed 5, Claims for expenses in excess of the 2,500 basic allowance will only be made where receipts are provided for the whole cost incurred and where those costs are reasonable. 53. The funeral expenses may include items such as: provision of a funeral; tombstone; flowers; newspaper announcements; funeral breakfasts / non-alcoholic refreshments; memorials; transporting the deceased back to their country of origin. 54. The list above is not exhaustive. Where there are good reasons, we will consider other costs if they are supported by receipts.